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Deep Venous Thrombosis

Thrombosis refers to the formation of a blood clot. Deep venous thrombosis refers to clot formation (most commonly) in the lower extremities. The release of the clot, allowing it to travel through the bloodstream, is known as embolization. This can result in clot entrapment in the lungs, a clinical entity known as pulmonary embolism.

Causes:

Deep venous thrombosis or DVT is common in several different situations.

  • Pregnancy
  • Chronically bedridden or wheelchair bound patients
  • Elderly patients
  • Immediate post operative patients (especially abdominal and orthopedic surgery)
  • Women using birth control pills
  • Patients with a history of prior deep venous thrombosis

Symptoms:

Common symptoms include unilateral leg (calf) swelling and pain.

Diagnosis:

  • Common symptoms include unilateral leg (calf) swelling and pain
  • History and physical examination for the findings consistent with DVT
  • Venography, which involves an injection of a radio-opaque contrast dye into a foot vein, provides X-ray illumination of the lower extremity venous system. Echocardiography (Doppler) has offered a painless noninvasive alternative for diagnosis.
  • Blood tests (i.e. blood count and coagulation profile) will also be performed.

Treatment:

Treatment will involve the use of medications (heparin) to inhibit clot formation. This anticoagulant medication is generally given in the hospital by IV route with close observation for signs and symptoms of pulmonary embolism. Leg elevation, bed rest, and warm compresses may also be indicated. Oral anticoagulant medication (warfarin) may be necessary longer term in some of the patients.

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